Publisher : Independently Published
Release : 2019-02-15
ISBN : 9781796971309
Language : En, Es, Fr & De
Book Description :
Sleep problems are one of the most common complaints for adults in primary care. They are associated with a decline in overall health status and perception of poor health and can have negative personal and social consequences. The term insomnia is variously defined and can describe a symptom and/or a disorder. It involves dissatisfaction with sleep quantity or quality and is associated with one or more of the following subjective complaint(s): difficulty with sleep initiation, difficulty maintaining sleep, or early morning waking with inability to return to sleep. Individuals with sleep problems also report higher levels of anxiety, physical pain and discomfort, and cognitive deficiencies. Insomnia may be associated with long-term health consequences, including increased morbidity, respiratory disease, rheumatic disease, cardiovascular disease, cerebrovascular conditions, and diabetes. While insomnia is typically transient, some cases are persistent and can last for years. 'Insomnia disorder' should be diagnosed using diagnostic criteria from the American Psychiatric Association's Diagnostic and Statistical Manual (DSM) and/or the International Classification of Sleep Disorders (ICSD). Both have been recently updated. The fifth edition of the DSM (DSM-5) is geared towards primary care and general mental health providers. Criteria for insomnia disorder require that sleep symptoms cause clinically significant distress or impairment(s) in functioning (social, occupational, educational, academic, behavioral, or other) and occur despite adequate opportunity for sleep on at least 3 nights per week for at least 3 months. Diagnosis also requires that symptoms not be primarily linked to other sleep disorders or occur exclusively during the course of another sleep-wake disorder (narcolepsy, breathing-related sleep disorder, circadian rhythm disorder); not be attributable to the physiological effects of a substance; and not be explained by coexisting mental disorders or medical conditions. Dysfunction associated with insomnia disorder includes fatigue, poor cognitive function, mood disturbance, and distress or interference with personal functioning. Both criteria recognize sleep-related complaint(s) despite adequate opportunity for sleep combined with distress or dysfunction created by the sleep difficulty in their current and previous versions. Until recently, diagnostic criteria classified insomnia as primary or comorbid, depending on the absence or presence of other conditions. However, the DSM-5 now uses the term "insomnia disorder" and ICSD-III uses the term "insomnia;" both eliminate the distinction between primary and secondary insomnia. The distinction had questionable relevance in clinical practice, and revisions reflect this understanding by suggesting a diagnosis of insomnia disorder for patients who meet diagnostic criteria, despite any coexisting conditions, unless the other condition explains the sleep problems.Depending on how insomnia is defined, prevalence estimates range from nearly 33 percent in an international sample of primary care patients to 17 percent of U.S. adults reporting "regularly having insomnia or trouble sleeping in the past 12 months" to 6-10 percent of adults meeting established diagnostic criteria. Insomnia disorder in the general population consists of difficulties getting to sleep and maintaining sleep. Females are 1.4 times more likely than males to suffer from insomnia. Older adults also have higher prevalence of insomnia; aging is often accompanied by changes in sleep patterns (disrupted sleep, frequent waking, early waking) that can lead to insomnia. Older adults typically report difficulty maintaining sleep. Many insomnia cases coexist with other conditions (especially psychiatric diagnoses and pain disorders) however, current diagnostic criteria suggest that insomnia disorder includes sleep problems that cannot be explained by another mental or medical condition.